An investigation of a new cutaneous leishmaniasis endemic area in Western Sri Lanka

Background: The aim was to investigate an emerging focus of cutaneous leishmaniasis (CL) in Gampaha district, Western Sri Lanka. Methods: Sociodemographics of CL patients in Mirigama, Gampaha district, were compared with controls using a structured questionnaire. Clinical data and geographic positioning system coordinates of patients were recorded. Sandflies collections were performed in four selected sites using indoor hand collection (162 units) and cattle-baited net traps (n=3). Results: Of 73 patients (mean age 43.6 y; SD 20), 58.9% were males. Lesions consisted of nodules (52.1%) and ulcers (47.9%). Single Lesions were seen in 69.9% of patients, while 30.1% had multiple Lesions. Except for one mucosal Lesion, all the others were cutaneous. Treatment consisted of sodium stibogluconate and cryotherapy (46.6%), sodium stibogluconate (45.2%) or cryotherapy (8.2%). Multiple Lesions were more Likely to receive combination therapy (p=0.013). The majority of those employed (81.1%; 27/33) were engaged in outdoor work. Male gender, Low education attainment and poor disease awareness were significant risk factors for CL (p<0.05). Four households reported multiple cases. Phlebotomus argentipes was detected in all cattle-baited net traps and 35.3% of indoor hand collection units. Conclusions: CL is emerging in Gamapha district with Mirigama as the epicentre. Case distribution indicates Local transmission, with P. argentipes as the probable vector.

Automated summary

An investigation was conducted in Gampaha district, Western Sri Lanka, to study the emerging focus of cutaneous leishmaniasis. The study found that male gender, low education attainment, and poor disease awareness were significant risk factors for CL. Local transmission was indicated, with P. argentipes as the probable vector.